Analysis of hypothermia through the acute phase in major burns patients: Nursing care. / Análisis de la hipotermia durante la fase aguda del paciente gran quemado: cuidados enfermeros.

Major burns patients usually present hypothermia after suffering a thermal burn, due to exposure during the accident, cooling of the burn and transfer. There are methods of reheating to avoid this heat loss, where nursing care is key. OBJECTIVE: To analyse the constant temperature presented by large burns patients on admission to the Burns Unit and their progression over the first 72hours. METHOD: Retrospective cross-sectional descriptive observational study of patients with thermal burns affecting more than 15% of body surface area, from December 2010 to May 2018. By reviewing databases and clinical records, demographic data, qualitative variables (origin of burn, previous pathologies, mechanical ventilation and ABSI and BOBI scales) and quantitative variables (burn depth and extension, temperature at admission and taken every 8hours for 72hours). Absolute, relative frequencies and the statistics of the quantitative variables were analysed. The study was verified by statistical tests according to the variables and contingency tables. A logistic regression model was developed expressed in a ROC curve. RESULTS: Of the 57 patients included, 79.2% developed hypothermia on admission. They presented burns over 34.56%±16.64 of their body surface, with 28.04%±17.49 being deep burns. Mortality during the stay was 29.8%. The presence of hypothermia during the acute phase was statistically related to death during stay in the unit (p=.033). It was observed that hypothermia is directly related to the extent of the burn (p=.003). CONCLUSIONS: Due to the presence of hypothermia on admission, and to the fact that the average temperature does not exceed 36°C until at least 16hours after the burn, nurses must know and promptly administer adequate reheating measures to improve chances of survival in major burns.

Effect of elastic-band exercise on muscle damage and inflammatory responses in Taekwondo athletes / Efeito do exercício com banda elástica sobre a lesão muscular e as respostas inflamatórias em atletas de Taekwondo / Efectos de los ejercicios con banda elástica sobre la lesión muscular y las respuestas inflamatorias en atletas de Taekwondo

INTRODUCTION: Elastic bands offer variable elastic resistance (ER) throughout a range of motion and their incorporation with exercise movements has been used for variable strength training and rehabilitation purposes. Objective: Investigate the effect of acute bout of progressive elastic-band exercise on muscle damage and inflammatory response in Taekwondo athletes (TKD) compared with untrained ones.METHODS: Fourteen (TKD, n = 7 and untrained, n = 7) men performed 3 sets of progressive resistance elastic exercise. Blood samples were taken pre-exercise and also immediately and 24h post exercise. Delayed onset muscle soreness (DOMS), creatine kinase (CK) and lactate dehydrogenase (LDH) activity, total leukocyte counts, interleukin-6 and C-reactive protein (CRP) were analyzed.RESULTS: Only DOMS increased in untrained group, but elevation of DOMS was observed in both groups (TKD and untrained) at 24h after exercise (p<0.05). CK and LDH activity increased in both groups significantly. Also TKD group only showed CK increasing 24h post exercise (p<0.05). Total circulating leukocyte counts increased immediately in post exercise experiments and decreased in 24h ones in both groups (p<0.05). Serum IL-6 immediately increased in both groups and 24h post exercises but there was no significant difference between immediate and 24h post exercise experiments in TKD group. Furthermore, CRP just increased 24h after exercise in both groups (p<0.05).CONCLUSION: Progressive resistance elastic exercise induced muscle damage and inflammation in TKD athletes, but also had smaller changes in comparison with untrained group and other forms of exercise.

INTRODUÇÃO: As bandas elásticas oferecem resistência elástica (RE) variável em toda a amplitude de movimento, e sua incorporação aos movimentos de exercício tem sido utilizada para fins variáveis de treinamento de força e de reabilitação. Objetivo: Investigar o efeito de ciclos agudos de exercício progressivo com banda elástica sobre os danos e respostas inflamatórias dos músculos em atletas de Taekwondo (TKD), em comparação com os indivíduos não treinados.MÉTODOS: Catorze (TKD, n=7 e não treinados, n=7) homens realizaram três conjuntos de exercício elástico com resistência progressiva. Foram coletadas amostras de sangue antes, imediatamente após e 24 horas depois do exercício. Procederam-se às seguintes análises: dor muscular de início tardio (DMIT), atividade da creatina quinase (CK) e da lactato desidrogenase (LDH), contagem total de leucócitos, interleucina-6 e proteína C reativa (CRP).RESULTADOS: Só a DMIT aumentou no grupo não treinado, mas a elevação desse parâmetro foi constatada em ambos os grupos (TKD e não treinados) 24 horas depois do exercício (p < 0,05). A atividade da CK e da LDH aumentou significantemente nos dois grupos. Além disso, o grupo TKD só apresentou elevação da CK 24 horas depois do exercício (p < 0,05). As contagens totais de leucócitos circulantes aumentaram imediatamente nas experiências pós-exercício e caíram nas experiências às 24 horas em ambos os grupos (p < 0,05). A IL-6 sérica aumentou de imediato nos dois grupos e 24 horas depois dos exercícios, mas não se constatou diferença significante entre as experiências imediatas e depois de 24 horas no grupo TKD. Além disso, a CRP aumentou apenas 24 horas após o exercício nos dois grupos (p < 0.05).CONCLUSÃO: O exercício progressivo com banda elástica induziu danos musculares e inflamação nos atletas de TKD, tendo porém, alterações menores em comparação com o grupo não treinado e com outras formas de exercício.

INTRODUCCIÓN: Las bandas elásticas ofrecen resistencia elástica (RE) variable en toda la amplitud de movimiento, y su incorporación a los movimientos de ejercicios ha sido utilizada para fines variables de entrenamiento de fuerza y de rehabilitación. Objetivo: La finalidad del presente estudio fue investigar el efecto de ciclos agudos de ejercicios progresivos con banda elástica sobre los daños y respuestas inflamatorias de los músculos en atletas de Taekwondo (TKD), en comparación con los individuos no entrenados.MÉTODOS: Catorce (TKD, n=7 y no entrenados, n=7) hombres realizaron tres conjuntos de ejercicios elásticos con resistencia progresiva. Fueron colectadas muestras de sangre antes, inmediatamente después y 24 horas después de los ejercicios. Se procedió a realizar los siguientes análisis: dolor muscular de inicio tardío (DMIT), actividad de creatincinasa (CK) y de lactato deshidrogenasa (LDH), conteo total de leucocitos, interleucina-6 y proteína C reactiva (CRP).RESULTADOS: Sólo la DMIT aumentó en el grupo no entrenado, pero la elevación de ese parámetro fue constatada en ambos grupos (TKD y no entrenados) 24 horas después de los ejercicios (p < 0,05). La actividad de la CK y de la LDH aumentó significantemente en los dos grupos. Además, el grupo TKD sólo presentó elevación de la CK 24 horas después de los ejercicios (p < 0,05). Los conteos totales de leucocitos circulantes aumentaron inmediatamente en los experimentos post-ejercicio y cayeron en los experimentos a las 24 horas en ambos grupos (p < 0,05). La IL-6 sérica aumentó de inmediato en los dos grupos y 24 horas después de los ejercicios, pero no se constató diferencia significativa entre los experimentos inmediatos y después de 24 horas en el grupo TKD. Además de eso, la CRP aumentó solamente 24 horas después de los ejercicios en los dos grupos (p < 0.05).CONCLUSIÓN: Los ejercicios progresivos con banda elástica indujeron daños musculares e inflamación en los atletas de TKD habiendo, no obstante, alteraciones menores en comparación con el grupo no entrenado y con otras formas de ejercicio.